Study of family clusters of COVID-19 in the Ústí nad Labem Region with a focus on children – clinical picture, secondary transmission, antibody response
Authors:
J. Vičar 1; E. Patrasová 2; I. Stiborová 3; V. Balatka 1; F. Chvojka 1; O. Šácha 1; V. Král 3
Authors place of work:
Dětská klinika Fakulty zdravotnických studií Univerzity J. E. Purkyně v Ústí nad Labem a Krajské zdravotní, a. s. – Masarykova nemocnice v Ústí nad Labem, o. z.
1; Protiepidemický odbor, Krajská hygienická stanice Ústeckého kraje se sídlem v Ústí nad Labem, 3. lékařská fakulta Univerzity Karlovy v Praze
2; Centrum imunologie a mikrobiologie Zdravotního ústavu se sídlem v Ústí nad Labem
3
Published in the journal:
Epidemiol. Mikrobiol. Imunol. 70, 2021, č. 4, s. 223-232
Category:
Original Papers
Summary
Objective: The article presents the results of a study of family clusters of COVID-19 whose aim was to describe the clinical course of the disease in children, to identify secondary transmission in households with infected children, and to find out the differences in the antibody response between children and adults. Data were collected from 3 March 2020 to 25 October 2020, that is at the time when the alpha or delta variants were not dominant.
Methods: A retrospective analysis of data on infected children in the Ústí nad Labem Region collected by the Regional Public Health Authority along with questionnaire data reported by their families. Serological tests were performed in study volunteers.
Results: The most common symptoms in children were headache, runny nose, and loss of smell and taste. The hospital admission rates were 0.8% in children and 2.4% in adults. The secondary transmission rate in families where the index case was a child reached 22.6%. It was higher when the index case was a child 11-15 years of age or asymptomatic. The secondary transmission rate in families where the index case was an adult equalled 77.1%. Children had higher IgG antibody levels than adults at post-infection months 4 and 5, but their seropositivity rate was comparable to that of adults.
Conclusion: Children have a nonspecific clinical course of the disease, which is quite similar as other viroses, and rarely require hospital admission. Secondary transmission in families where the index case was a child is not uncommon and is also possible through contact with an asymptomatic child. After recovery, children have higher levels of antibodies at post-infection months 4 and 5.
Keywords:
Antibodies – COVID-19 – children – clusters – secondary transmission
Zdroje
1. European Centre for Disease Prevention and Control (ECDC). COVID-19 in children and the role of school settings in COVID-19 transmission, 06 August 2020. Dostupné na www: https://www. ecdc.europa.eu/en/publications-data/children-and-school-settings- covid-19-transmission. Accessed: 13 October 2020.
2. Grijalva CG, Rolfes MA, Zhu Y, et al. Transmission of SARS-COV-2 Infections in Households — Tennessee and Wisconsin, April– September 2020. MMWR Morb Mortal Wkly Rep, 2020;69:1631– 1634. DOI: http://dx.doi.org/10.15585/mmwr.mm6944e1.
3. Buonsenso D., et al. Seroprevalence of anti-SARS-CoV-2 IgG antibodies in children with household exposure to adults with COVID-19: Preliminary findings. Pediatrics Pulmonology, 2021; 1–4; doi.org/10.1002/ppul.25280.
4. Dietz K. The estimation of the basic reproduction number for infectious diseases. Stat Methods Med Res., 1993;2(1):23–41. doi: 10.1177/096228029300200103.
5. Dong Y, Mo X, Hu Y, et al. Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China. Pediatrics, 2020; doi: 10.1542/peds.2020-0702.
6. Parri N, Lenge M, Buonsenso D. Coronavirus Infection in Pediatric Emergency Departments (CONFIDENCE) Research Group. Children with Covid-19 in Pediatric Emergency Departments in Italy [published online ahead of print, 2020 May 1]. N Engl J Med. doi:10.1056/NEJMc2007617.
7. Yonker LM, Neilan AM, Bartsch Y, Patel AB, Regan J, Arya P, Gootkind E, Park G, Hardcastle M, St. John A, Appleman L, Chiu ML, Fialkowski A, De la Flor D, Lima R, Bordt EA, Yockey LJ, D’Avino P, Fischinger S, Shui JE, Lerou PH, Bonventre JV, Yu XG, Ryan ET, Bassett IV, Irimia D, Edlow AG, Alter G, Li JZ, Fasano A, Pediatric SARS-CoV-2: Clinical Presentation, Infectivity, and Immune Responses. The Journal of Pediatrics, 2020. doi: https://doi. org/10.1016/ j.jpeds.2020.08.037.
8. Götzinger F, Santiago-García, B, Noguera-Julián A, et al. “COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.” Lancet Child Adolesc Health. Dostupné na www: https://doi.org/10.1016/S2352-4642(20)30177-2.
9. Lei H, Xu X, Xiao S, Wu X, Shu Y. Household transmission of COVID-19-a systematic review and meta-analysis. J Infect, 2020. Dostupné na www: https://www.journalofinfection.com/article/ S0163-4453(20)30571-5/fulltext.
10. Viner RM, Mytton OT, Bonell C, et al. Susceptibility to SARS-CoV-2 Infection Among Children and Adolescents Compared With Adults: A Systematic Review and Meta-analysis. JAMA Pediatr, 2021;175(2):143–156. doi:10.1001/jamapediatrics.2020.4573.
11. Enrico Lavezzo, Elisa Franchin, Constanze Ciavarella, et al. Suppression of COVID-19 outbreak in the municipality of Vo, Italy, medRxiv 2020.04.17.20 doi: https://doi.org/10.1101/2020.04.17.20053157.
12. de Lusignan S, Dorward JA, Correa N, et al. “Risk factors for SARSCoV- 2 among patients in the Oxford Royal College of General Practitioners Research and Surveillance Centre primary care network: a cross-sectional study.” Lancet Infect Dis, 2020. Dostupné na www: https://doi.org/10.1016/S1473-3099(20)30371-6.
13. Eli S Rosenberg, Elizabeth M Dufort, Debra S Blog, et al. New York State Coronavirus 2019 Response Team, COVID-19 Testing, Epidemic Features, Hospital Outcomes, and Household Prevalence, New York State. Clinical Infectious Diseases, 2020. Dostupné na www: https://doi.org/10.1093/cid/ciaa549.
14. Fung HF, Martinez L, Alarid-Escudero F, et al. The household secondary attack rate of SARS-CoV-2: A rapid review [published online ahead of print, 2020 Oct 12]. Clin Infect Dis, 2020;ciaa1558. doi:10.1093/cid/ciaa1558.
15. Buitrago-Garcia D, Egli-Gany D, Counotte MJ, Hossmann S, Imeri H, Ipekci AM, et al. Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: A living systematic review and meta-analysis. PLoS Med, 2020;17(9): e1003346. Dostupné na www: https://doi. org/10.1371/journal.pmed.1003346.
16. Shah K, Saxena D, Mavalankar D. Secondary attack rate of COVID-19 in household contacts: a systematic review, QJM. An International Journal of Medicine, 2020; 113(12): 841–850. Dostupné na www: https://doi.org/10.1093/qjmed/hcaa232.
17. Maltezou HC, Vorou R, Papadima K, et al. Transmission dynamics of SARS‐CoV‐2 within families with children in Greece: A study of 23 clusters. J Med Virol, 2020:1–7. Dostupné na www: https://doi.org/10.1002/jmv.26394.
18. Wei Li, Bo Zhang, Jianhua Lu, Shihua Liu, Zhiqiang Chang, Cao Peng, Xinghua Liu, Peng Zhang, Yan Ling, Kaixiong Tao, Jianying Chen. Characteristics of Household Transmission of COVID-19. Clinical Infectious Diseases, 2020; 71(8):1943–1946. Dostupné na www: https://doi.org/10.1093/cid/ciaa450.
19. Watson J, Whiting PF, Brush JE. Interpreting a covid-19 test result. BMJ, 2020;369:m1808.
20. Alter G, Seder R. The Power of Antibody-Based Surveillance. N Engl J Med, 2020. DOI: 10.1056/NEJMe2028079. Dostupné na www: https://www.nejm.org/doi/full/10.1056/NEJMe2028079.
21. Lopez Bernal JP, N, Byers C, et al. Transmission dynamics of COVID-19 in household and community settings in the United Kingdom. MedRxiv, 2020. Dostupné na www: https://doi.org/ 10.1101/2020.08.19.20177188.
22. Cao Y, Wang Y, Das A, Pan CQ, Xie W. Transmission dynamics of COVID-19 among index case family clusters in Beijing, China. Epidemiol Infect, 2020; 149:e74. doi: 10.1017/ S0950268820002848.
23. Weisberg SP, Connors TJ, Zhu Y, et al. Distinct antibody responses to SARS-CoV-2 in children and adults across the COVID-19 clinical spectrum. Nat Immunol, 2021; 22:25–31. Dostupné na www: https://doi.org/10.1038/s41590-020- 00826-9.
24. Waterfield T, Watson C, Moore R, et al. Seroprevalence of SARS- -CoV-2 antibodies in children – A prospective multicentre cohort study. MedRxiv, 2020.08.31.20183095. doi: https://doi.or g/10.1101/2020.08.31.20183095.
25. Felenstein S, Hedrich CM. SARS-CoV-2 infection in children and young people. Clinical Immunology,2020; 220:108588. doi.org/10.1016/j.clim.2020.108588.
26. Zimmermann P, Curtis N. Coronavirus Infection in Children Including COVID-19. An Overwiev on the Epidemiology, Clinial Features, Diagnosis, Tratment and Prevention Options in Children. The Pediatric Infectious Diseases Journal, 2020; 39(5). doi. org/1031097/INF.0000000000002660.
27. Sposato B, Scalese M. Why do children seem to be more protected against COVID-19? A hypothesis. Medical Hypothesis, 2020; 143:110151. doi.org/10.1016/j.mehy.2020.110151.
28. Wong LSY, et al. Age-Relatd Differences in Immunological Responses to SRS-CoV-2. J Allergy Clin Immunol Pract, 2020;8(10). doi.org/10.1016/j.jaip.2020.08.026.
29. World Health Organization. Home care for patients with suspected or confirmed COVID-19 and management of their contacts, 2020. Dostupné z www: https://www.who.int/publications/ i/item/home-care-for-patients-with-suspected-novel- coronavirus-(ncov)-infection-presenting-with-mild-symptoms- and-management-of-contacts.
30. Liu Y, Eggo RM, Kucharski AJ. Secondary attack rate and superspreading events for SARS-CoV-2. Lancet, 2020; 395(10227):e47. doi: 10.1016/S0140-6736(20)30462-1.
Štítky
Hygiene and epidemiology Medical virology Clinical microbiologyČlánok vyšiel v časopise
Epidemiology, Microbiology, Immunology
2021 Číslo 4
Najčítanejšie v tomto čísle
- Mumps and its occurrence in the Czech Republic and Slovakia
- Possibilities for the analysis of peripheral blood B cell subpopulations in a routine immunological laboratory
- Corynebacterium sp. isolated from blood culture of a bacteremic patient. Will the assumptions about a new corynebacterium be confirmed?
- Prevalence and management of arterial hypertension in the population aged 25–64 in the Czech Republic with a focus on diabetic patients